Provider Demographics
NPI:1962561746
Name:WILLIAMS, MICHAEL SETH (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SETH
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 PELHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1322
Mailing Address - Country:US
Mailing Address - Phone:205-664-1575
Mailing Address - Fax:205-664-1578
Practice Address - Street 1:2617 PELHAM PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1322
Practice Address - Country:US
Practice Address - Phone:205-664-1575
Practice Address - Fax:205-664-1578
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-B45-TA-738152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051005425OtherBLUE CROSS AND BLUE SHIEL
AL051005425OtherBLUE CROSS BLUE SHIELD
AL051558703Medicaid
AL009913279Medicaid
AL051005425OtherBLUE CROSS AND BLUE SHIEL
ALV12439Medicare UPIN
AL051005425OtherBLUE CROSS BLUE SHIELD